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The RNA group of viruses is classified into three orders that include the order Nidovirales, which is further classified into four families: the Coronaviridae, Arteriviridae, Mesoniviridae, and Roniviridae. The family Coronaviridae is further divided into two subfamilies: Coronavirinae and Torovirinae. The Coronavirinae subfamily includes four genera of viruses (Alphacoronaviruses, Betacoronaviruses, Gammacoronaviruses, and Deltacoronaviruses), which have been grouped primarily based on serology and phylogenetic clustering (divisions based on the habitat/genetic relatedness) [5]. The detailed classification along with the origin of severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) is depicted in Figure 1.

The CoVs belong to the order Nidovirales, family Coronaviridae, and the subfamily Coronavirinae. They are genetically categorized into four important genera: the Alphacoronavirus, Betacoronavirus, Gammacoronavirus, and Deltacoronavirus. The former two genera typically infect mammals, whereas the latter two predominantly infect birds [9,17-18].

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CoV proteins, structural, enzymatic, and accent proteins play key roles in the pathogenesis of the CoV disease (COVID). Structural proteins, in addition to their role in the maintenance of virion shape and morphogenesis, also contribute to the viral spread in vivo and antagonizing host cellular and immune responses. Nonstructural proteins include the small accent proteins that are not at all conserved among mouse hepatitis virus (MHV) and SARS-CoVs and the 16 conserved proteins encoded in the replicase locus, a lot of which have an enzymatic role in RNA metabolism or protein processing, which further assists the viruses in antagonizing hosts immune responses during infections [9,14].

CoVs naturally cause illnesses in mammals and birds that include enteritis in cows and pigs and respiratory diseases in chickens. They may also be responsible for potentially lethal respiratory tract infections (acute and chronic) in humans [5,9]. From the available preliminary clinical data, SARS can develop in COVID in stages, consisting of acute constitutional signs and symptoms, acute viral pneumonitis, acute lung damage, or even acute respiratory distress syndrome, evolving over one to two weeks. The preliminary infection could be followed by a hyperactive immune reaction, which seems to underlie the severe manifestations of SARS [41].

Generally, early clinical signs of COVID can be similar to other seasonal viral respiratory illnesses, thereby limiting the ability of the physicians to suspect the disease at its early stages. Respiratory symptoms frequently increase from two to seven days after the onset of infection and usually include a non-productive cough and dyspnea. More severe respiratory symptoms along with rhinorrhea and sore throat may arise, which are unusual. Patients with positive laboratory tests for SARS-CoV may show advanced radiographic changes of lung indicating pneumonia after 7-10 days of infection. Many CoV infected patients (70-90%) were noted to develop lymphopenia [6].

Laboratory tests, which are currently available for the diagnosis of SARS-CoV-2 in various human clinical specimens (Sputum, throat swab, nasal secretions, feces, blood/serum/plasma), include real-time polymerase chain reaction (RT-PCR), viral cultural techniques for the isolation of virus from clinical specimens, immunological tests for the detection of antibodies and antigens such as enzyme-linked immunosorbent assay, indirect fluorescent antibody technique, rapid immunochromatographic tests, and immunofluorescence techniques [7]. Other tests that may assist in the diagnosis may include the flow-cytometry analysis for CD4+ and CD8+ T cell counts, chest radiography (pneumonia), complete blood picture (to demonstrate lymphopenia), and serum biochemistry (serum protein and others) [9-10,13-14,41,43-44].

While most CoVs cause a mild common cold-like condition in human beings (children and adults), the emergence of the agents such as SARS and SARS-associated CoVs under the subgenus Betacoronavirus highlight the nature of adaptability and genetic variations of CoVs and their potential to cause significant/serious human illnesses. Because of their novel nature and the unavailability of specific anti-viral agents and a vaccine, isolation and quarantine of exposed/infected persons appear to be of increased significance to control and prevent the spread of the virus among the general population [9,45].

Anti-viral treatment with interferon-alpha inhalation (50 g two times daily), lopinavir and ritonavir (anti-retroviral drugs) (400 mg twice each day and 100 mg twice every day, respectively), and arbidol (200 mg two times every day) is recommended. Patients obtained treatment with a corticosteroid (40-80 mg/day) and gamma globulin (15-20 g/day) for three to five days while their resting respiratory rate became greater than 30 per minute, or oxygen saturation was under 93% without oxygen, or multiple pulmonary lobes showed more than 50% progression of sickness in 48 hours on imaging. Patients additionally may be treated with probiotics to relieve gastrointestinal illness. Quinolones and higher generation cephalosporins (oral and intravenous) can be administered if fever lasted for more than seven days or C-reactive protein levels were 30 mg/L or more (normal range: 0-8 mg/L). After the course of treatment, the patients infected with SARS-CoV-2 can be discharged from the hospital only after two negative results of the samples collected with 24-hour interval using an RT-PCR [13]. Other drugs like chloroquine (anti-malaria drug), hydroxychloroquine (used to treat rheumatoid arthritis, Lupus), azithromycin (anti-bacterial drug), and favipiravir are all either drugs recommended for other causes (repurposed) or drugs that are under clinical trials to treat serious infections caused by SARS-CoV-2.Protease inhibitors (lopinavir/ritonavir) in combination with ribavirin may be used for anti-viral therapy in the early phase, and nelfinavir was found to be a promising alternative. The role of interferon and systemic corticosteroid therapy in preventing immune-mediated lung injury requires further investigation. Besides, other anti-viral treatments, RNA interference, monoclonal antibody, synthetic peptides, and vaccines are being developed [42]. Corticosteroids can be used to limit excessive lung damage due to an inflammatory response, and a high flow of oxygen supplementation and mechanical ventilation can be used in cases of respiratory failure [41]. Tracheostomy may be performed in patients who require prolonged mechanical ventilation and longer intensive care unit (ICU) stay. Strict adherence to infection control guidelines is mandatory while performing tracheostomy in the ICU or operating rooms, as well as during subsequent changes of the tracheostomy tube. Care should be taken during the treatment procedures to reduce complications and the chances of transmission [30]. The use of high-dose pulse methylprednisolone during the clinical course of a SARS outbreak was associated with clinical improvement, but randomized controlled trials are needed to ascertain its efficacy [49].

Bell's palsy is also known as acute peripheral facial palsy of unknown cause. It can occur at any age. The exact cause is unknown. Experts think it's caused by swelling and inflammation of the nerve that controls the muscles on one side of the face. It could be caused by a reaction that occurs after a viral infection.

After several years as trainees under ShowBT Philippines, SB19 debuted in 2018 with the single "Tilaluha". They saw little attention until their dance practice video for their song "Go Up" went viral in late 2019, leading them to strategically use social media to gain popularity. They became the first Southeast Asian act to be nominated on the Billboard Music Awards,[2][3] and the first Southeast Asian act to make an appearance in the top 10 of the Billboard Social 50.[4][5] SB19 promotes its music as part of Pinoy pop, a popular sub-genre of Original Pilipino Music.[6]

SB19 debuted on October 26, 2018, with the single "Tilaluha",[15] a sentimental ballad. It was followed by their fast-paced second single "Go Up",[11] which was released on July 19, 2019.[16] The group had received little attention, and its members began to grow disheartened.[13] They had decided to disband if they did not see success after "Go Up". However, several months after "Go Up" released, their dance practice video for the song went viral on Twitter and Facebook. As a result, SB19 was able to secure spots on Philippine television and radio. The newfound opportunity led them to use social media as a strategy to gain popularity and start planning a tour.[17][18][19]

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